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General NPI Number Information
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NPI Number | 1295991461
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Entity Type | Organization
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Legal Business Name | MESA COUNTY GOVERNMENT
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Dates
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Enumeration Date | 08/06/2008
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 650 SOUTH AVE
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-7717
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Country | US
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Telephone | 970-244-3300
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Fax | 970-241-0836
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Provider Business Mailing Address
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Address Line | 650 SOUTH AVE
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-7717
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Country | US
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Telephone | 970-244-3300
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Fax | 970-241-0836
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Authorized Official
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Title or Position | DEPARTMENT DIRECTOR
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Name | MR. DENNIS BERRY
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Credential |
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Telephone | 970-244-3331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1538-03
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1538-01
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 1538-03
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License Number State | CO
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